Parenting Plan Part A and Part B Form

Parenting Plan

Exhibit

IN THE CIRCUIT COURT OF , MISSOURI

(County where court is located. City of Saint Louis is considered a county.)

Part A - Custody of the Children

1. Plan Author(s) (Check all applicable boxes)

Both parents wrote this Parenting Plan.

Petitioner / Respondent wrote this Parenting Plan. (Check Petitioner or Respondent if you choose this option)

The court wrote this Parenting Plan.

The Guardian ad Litem wrote this Parenting Plan.

Other

2. Names and Ages of Children

Enter the total number of children to whom this Parenting Plan applies: .

The names and ages of the children (hereinafter referred to simply as “the children”) are as follows:

3. Duration of Plan

The terms and conditions set forth in this Parenting Plan shall remain in full force and effect until the children are emancipated or until this plan is modified by a court of competent jurisdiction.

4. Types of Decisions

The three types of decisions that parents must make concerning their children are major decisions, daily or everyday decisions, and emergency decisions.

5. Access to Medical, Dental and Educational Records of the Children

Unless otherwise provided in this Parenting Plan, both parents are entitled to access records and information pertaining to the children, including, but not limited to, full and complete medical, dental, and educational records subject to Part A, Paragraph 21.

6. Legal Custody (Check one of the three boxes)

Joint Legal Custody

Sole Legal Custody Petitioner Respondent

Third Party - Sole Legal Custody to Third Party

7. Communication between Parents (Check each box that is appropriate in your case)

In person

Home telephone

Work telephone

Mobile telephone

Letter via U.S. Postal Service

E-mail

Using the following third person:

8. Issues not to be Discussed in the Presence of the Children

The parents shall not make negative, derogatory or degrading statements about the other parent in front of the children.

9. Dispute Resolution Procedure

10. Physical Custody (Check one of the four boxes)

Joint Physical Custody Petitioner Respondent

Sole Physical Custody with Visitation to the Other Parent Petitioner Respondent

Sole Physical Custody and Supervised Visitation to the Other Parent Petitioner Respondent

Visitation will be supervised by

11. Residential Schedules

12. Holidays

Holiday Exchange Schedule

13. Vacation Schedule (Check one of the two boxes)

No specific weeks will be set aside for our vacations.

Each parent may designate week(s) each year...

14. Location of Exchanges (Check one of the four boxes)

All exchanges shall occur at the children’s school or child care provider.

All exchanges shall occur at Petitioner’s Respondent’s residence.

The parent receiving custody of the children shall pick up the children at the other parent’s residence.

15. Transportation

Each parent will pay the expenses associated with his or her own transportation to and from the exchange location unless otherwise indicated in this Parenting Plan.

16. Notification of Change from Residential Schedule

In the event either parent cannot exercise the scheduled time with the children, he or she should tell the other parent as soon as possible...

17. Telephone Contact with Children (Check one of the two boxes)

Neither parent may contact the children at the other parent’s residence earlier than a.m. or later than p.m.

There are no restrictions on the time to contact the children.

18. Children’s Activities

The parent who has the children at the time of the activity is responsible for getting the children to their school or extracurricular activities.

19. Relocation

20. Domestic Violence (Check one of the three boxes)

There has been no pattern of domestic violence between the parents.

There has been a pattern of domestic violence between the parents, with Petitioner Respondent committing violent acts...

There has been a pattern of domestic violence between the parents, with both parents committing violent acts...

21. Educational Records and Domestic Violence (Check one of the three boxes)

There has been no domestic violence by either parent.

Educational records shall not include address information. Petitioner Respondent

Educational records may include address information. Petitioner Respondent

Part B - Support of the Children

1. Plan Author(s) (Check all applicable boxes)

Both parents wrote this Parenting Plan.

Petitioner / Respondent wrote this Parenting Plan.

The court wrote this Parenting Plan.

The Guardian ad Litem wrote this Parenting Plan.

Other

2. Names and Ages of Children

Enter the total number of children to whom this Parenting Plan applies: .

3. Parent to Pay Child Support (Check one of the two boxes)

Petitioner Respondent will pay regular monthly child support to Petitioner Petitioner Respondent.

No regular monthly child support will be paid by either parent. Petitioner Respondent will be referred to as parent paying support.

4. Parent Responsible for Medical Insurance (Check one of the three boxes)

Neither parent is required to maintain medical insurance for the benefit of the children.

Petitioner / Respondent shall maintain and pay the cost of medical insurance for the benefit of the children.

5. Parent Responsible for Dental Insurance (Check one of the three boxes)

Neither parent is required to maintain dental insurance for the benefit of the children.

Petitioner / Respondent shall maintain and pay the cost of dental insurance for the benefit of the children.

6. Medical and Dental Insurance for the Children

The total cost of medical and/or dental insurance paid by Petitioner for the minor children is $ per month.

The total cost of medical and/or dental insurance paid by Respondent for the minor children is $ per month.

7. Medical, Dental, Vision, or Psychological Expenses not Covered by Insurance

8. Payment of Uninsured Extraordinary Medical Costs

9. Work-Related Child Care Costs

The work-related child care expenses of the parent receiving support are $ per month.

The work-related child care expenses of the parent paying support are $ per month.

10. Child Care Expenses Unrelated to Employment

Incidental child care costs not related to employment are to be paid by the parent with physical custody at the time the child care costs are incurred.

11. Educational Expenses for College or Post-Secondary Education

12. Extraordinary Child-Rearing Costs

13. Payment of Extraordinary Child-Rearing Costs of the Children

14. Presumed Monthly Amount of Child Support

Six or More Children: $

Five Children: $

Four Children: $

Three Children: $

Two Children: $

One Child: $

15. Should the court order the presumed monthly amount of child support?

Yes. The court-ordered child support is the same as the presumed children support amount.

No. The court-ordered child support is different than the presumed children support amount.

16. Court-Ordered Child Support (Check all applicable boxes)

Six or More Children - $ per month

Five Children - $ per month

Four Children - $ per month

Three Children - $ per month

Two Children - $ per month

One Child - $ per month

17. Starting Date for Child Support

The first child support payment is due on the date of the entry of the judgment.

The first child support payment is due on

18. Income Tax Dependents

19. Method of Payment of Child Support

Child support shall be paid through income withholding.

Child support shall be paid directly to the Family Support Payment Center.

Child support shall be paid directly to the parent receiving support.

20. Additional Provisions Pertaining to Support of the Children

Child Support Calculations / Form 14 and Tables